A nurse is caring for a client who is receiving peritoneal dialysis and notes a decrease in the dialysate flow rate. Which of the following actions should the nurse take? (Select all that apply)
Raise the drainage bag above the level of the client’s abdomen
Elevate the client to the high-Fowler’s position
Measure the amount of the dialysate outflow
Monitor the access site for drainage
Reposition the client onto the other side
Correct Answer : C,D,E
Choice A reason: Raising the drainage bag above the abdomen reverses gravity flow, stopping dialysate outflow and worsening the issue in peritoneal dialysis. Fluid drains downward naturally, so elevating the bag traps it, potentially causing discomfort or infection risk from stagnation. This action opposes dialysis mechanics, where the bag must stay low, making it contraindicated and detrimental to treatment efficacy.
Choice B reason: High-Fowler’s position (upright) may shift abdominal contents, but it doesn’t directly resolve catheter blockages or flow issues in peritoneal dialysis. It’s used during infusion to aid breathing, not drainage. Without evidence of respiratory distress, this adjustment lacks priority over actions addressing flow directly, like repositioning, rendering it less effective here.
Choice C reason: Measuring dialysate outflow quantifies the flow reduction, identifying if less fluid returns than infused, signaling obstruction or leakage. This data guides interventions, like catheter checks or flushes, ensuring dialysis removes toxins effectively. It’s a critical step in troubleshooting, providing objective evidence of the problem’s scope, essential for maintaining treatment goals.
Choice D reason: Monitoring the access site for drainage detects leaks or infection—common flow rate culprits—as fluid escaping reduces outflow. Peritonitis risk rises with poor site integrity, necessitating early intervention. This action ensures catheter function and patient safety, directly addressing potential causes of the observed decrease, making it vital.
Choice E reason: Repositioning to the other side relieves catheter kinks or omental wrapping, frequent causes of slow flow in peritoneal dialysis. Shifting position adjusts intra-abdominal pressure, freeing the catheter tip to drain properly. This non-invasive fix restores dialysis efficacy, a standard first-line response, directly tackling mechanical flow issues effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Choice A reason: Hypothyroidism requires lifelong levothyroxine because the thyroid gland doesn’t regain function in most cases, such as Hashimoto’s disease. Stating several months misleads the client, implying a temporary treatment, which is inaccurate. This chronic condition demands continuous hormone replacement to maintain metabolism, energy, and organ function. Temporary therapy applies to transient conditions, not primary hypothyroidism, so this statement fails to reflect the long-term nature of management needed.
Choice B reason: Hypothyroidism slows metabolism due to low thyroid hormone levels, reducing basal metabolic rate and calorie burning. This leads to weight gain as energy expenditure drops, even with unchanged diet, a common symptom. Educating clients about this helps them understand and manage expectations, linking it to the condition’s physiology. It’s a key teaching point, as weight gain often prompts diagnosis and motivates adherence to levothyroxine therapy.
Choice C reason: Laboratory tests like TSH and free T4 are essential to monitor levothyroxine’s effectiveness in hypothyroidism, ensuring the dose restores euthyroid status. These tests, typically done every 6-12 weeks initially then annually, guide adjustments to prevent under- or over-treatment. Including this in teaching empowers clients to participate in their care, understanding why follow-ups matter. It reflects standard practice for managing this endocrine disorder accurately.
Choice D reason: Increased perspiration is a hyperthyroidism symptom, where excess thyroid hormone accelerates metabolism, raising body heat. Hypothyroidism, conversely, causes cold intolerance and dry skin due to slowed metabolism, reducing sweat production. This statement contradicts hypothyroidism’s physiology, misinforming the client about expected symptoms. Correct teaching would highlight cold sensitivity instead, aligning with the condition’s impact on thermoregulation and skin.
Choice E reason: Hypothyroidism slows gastrointestinal motility due to decreased thyroid hormone, often causing constipation as a complication. A high-fiber diet increases bulk and promotes bowel movements, preventing this issue. Teaching this dietary adjustment addresses a common, manageable symptom, improving quality of life. It’s a scientifically supported recommendation, as fiber counteracts the sluggish digestion typical in hypothyroid states, making it vital education.
Correct Answer is A
Explanation
Choice A reason: Omega-3 fish oil, rich in EPA and DHA, lowers triglycerides by reducing hepatic VLDL production and enhances LDL clearance, cutting cholesterol levels. Clinical studies show it decreases cardiovascular risk in hyperlipidemia. For a client with high cholesterol, this supplement directly targets lipid metabolism, offering a therapeutic benefit, making it the appropriate choice here.
Choice B reason: Glucosamine, derived from shellfish, supports cartilage repair in osteoarthritis by aiding glycosaminoglycan synthesis, not affecting cholesterol pathways. It lacks lipid-lowering properties, focusing on joint health instead. For a client with high cholesterol, this supplement offers no benefit to lipid profiles, rendering it irrelevant to the goal of reducing levels.
Choice C reason: Cranberry tablets inhibit bacterial adhesion in the urinary tract, preventing infections, but have no impact on cholesterol metabolism or lipid levels. Their anthocyanins benefit bladder health, not cardiovascular risk factors. In high cholesterol, this supplement doesn’t address the condition, making it an ineffective choice for this client’s needs.
Choice D reason: Ginkgo biloba enhances cerebral blood flow via vasodilation, potentially aiding memory, but it doesn’t alter cholesterol synthesis or clearance. Its antioxidants target circulation, not lipids directly. For a client with high cholesterol, this supplement lacks evidence of lowering levels, failing to meet the therapeutic aim here.
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